ABC | Volume 111, Nº5, November 2018

Original Article Sokmen te al Cardiac functions in adrenal incidentaloma Arq Bras Cardiol. 2018; 111(5):656-663 Table 1 – Baseline characteristics of the study population Characteristics Non-functioning AI (n = 30) Control (n = 46) p value Age a (years) 51.77 ± 8.23 50.80 ± 6.62 0.46 Female sex c , n ( %) 25 (83.3) 41 (89.1) 0.84 BMI a (kg/m 2 ) 34.30 ± 4.63 32.43 ± 3,93 0.07 Diabetes mellitus c , n ( %) 3 (10) 6 (13) 0.76 Hypertension c , n (%) 5 (16.7) 8 (17.4) 0.94 DM and Hypertension c , n (%) 5 (16.7) 7 (15.2) 0.89 Systolic blood pressure a (mmHg) 131.33 ± 16.49 125.85 ± 12.36 0.07 Diastolic blood pressure a (mmHg) 81.57 ± 10.36 78.46 ± 10.62 0.21 Heart rate a (bpm) 82.93 ± 13.00 77.72 ± 9.19 0.09 Cortisol a (µg/dl) 12.88 ± 2.94 11.71 ± 3.80 0.15 Post DST cortisol a (µg/dl) 1.11 ± 0.38 0.70 ± 0.26 < 0.001* ACTH b (pg/ml) Median (Q1-Q3) 14,70(12,50–20,30) 22,40(13,70–35,70) 0.009* DHEAS b (µg/dl) Median (Q1-Q3) 55,15(27,90–86,30) 113(73,80–157,00) < 0.001* Fasting plasma glucose b (mg/dl) Median (Q1-Q3) 98(87,00–111,00) 97(84,00–113,00) 0.61 LDL cholesterol b (mg/dl) Median (Q1-Q3) 101,45(91,00–123,70) 109(91,90–135,00) 0.56 HDL cholesterol a (mg/dl) 45.50 ± 9.10 45.57 ± 9.49 0.97 Triglycerides b (mg/dl) Median (Q1-Q3) 116,50(84,00–153,00) 142(105,00–235,00) 0.1 a Independent samples t test; b Mann-Whitney U test ; Median (Q1-Q3): Median (1.Quartile-3.Quartile); c χ 2 test; *difference is statistically significant; AI: adrenal incidentaloma; BMI: body mass index; DM: diabetes mellitus; DST: dexamethasone supression test; ACTH: adrenocorticotrophic hormone; DHEAS: dedhydroepiandrostenedione sulphate; LDL: low-density lipoprotein; HDL: high-density lipoprotein. volume was subsequently placed at the level of LV lateral mitral annulus, septal mitral annulus and RV tricuspid annulus. The sampling window was positioned as parallel as possible to the myocardial segment of interest to obtain the optimal angle of imaging. Time intervals from the onset of P wave on the surface ECG to the beginning of the A wave (PA) representing atrial EMD were obtained from lateral mitral annulus, septal mitral annulus, and tricuspid annulus and named PA lateral, PA septum and PA tricuspid, respectively. The difference between PA lateral and PA tricuspid was defined as inter-atrial EMD (PA lateral-PA tricuspid), the difference between PA lateral and PA septumwas defined as intra-atrial EMD (PA lateral-PA septum). Peak systolic (Sm), early diastolic (Em), late diastolic (Am) velocities, and isovolumic contraction time (ICTm; time interval between the end of Am and the beginning of Sm), isovolumic relaxation time (IRTm; time interval between the end of Sm and the beginning of Em), and ejection time (ETm; time interval between the beginning and the end of Sm) were obtained from mitral and tricuspid annulus. Em/Am ratio for both ventricle and E/Em for LV were calculated. The myocardial performance index (MPI), a noninvasive Doppler measurement of global ventricular function incorporating both systolic and diastolic function, was calculated by the formula of (ICTm+IRTm)/ETm for both ventricles. Reproducibility Intraobserver variabilitywas assessed in 20 subjects randomly chosen from the participants, and the echocardiographic measurements were repeated under the same basal conditions. Simple random sampling method was used in the selection of 20 subjects. 1,96*(S w /√2n(m-1)) = confidence in the estimate formula was used to estimate the sample size for reproducibility. Reproducibility was evaluated by coefficient of variation. Intraobserver coefficients of variation were found to be nonsignificant (< 5%). Statistical Analysis Data were analyzed with Statistical Package for the Social Sciences (SPSS, Chicago, IL, United States) statistics, version 17.0 for Windows. Shapiro-Wilk test was used to test the normality of distribution for continuous variables. Continuous variables were expressed as means ± standard deviation. Non‑normal distributed variables were expressed as Median and quartiles (1.Quartile-3.Quartile). Categorical data were presented as numbers and percentages. Difference between groups was detected using χ 2 test for categorical variables. Mean values of continuous variables were compared between groups using Independent samples t-test or Mann-Whitney U-test, according to whether normally distributed or not. Correlation between continuous variables was evaluated by Pearson correlation tests. A linear regression analysis and generalized linear models were used to identify predictors of atrial EMD. P < 0.05 was considered statistically significant. Results Clinical and laboratory data of the study groups are given in Table 1. Age, gender, BMI, systolic and diastolic pressures, heart rate, and ratio of diabetic and hypertensive subjects were similar between groups (p > 0.05). ACTH and DHEAS 658